Health

Immunity to measles in a large population of varying age

Article Abstract:

An outbreak of measles in late 1988 and early 1989, in southern California, precipitated the screening of 660 hospital employees for the prevalence of immunity to the disease. Although previous research has reported that 90 percent or more of individuals born before 1957 are immune to measles, significant levels of morbidity were noted during the recent outbreak among individuals in this age group. In general, persons born before 1957 have not received measles vaccine. Voluntary hospital employee testing was conducted at the San Bernardino County Medical Center using an automated indirect fluorescent antibody technique. (The presence of a certain level antibodies against measles indicates previous exposure to the disease either through infection or by immunization.) Of the 660 individuals, 623 were willing to provide their date of birth. A total of 21 seronegative results were obtained, and an additional 13 cases were borderline. Seronegativity indicates that there has been no exposure to the virus, and hence, no immunity has developed. The results were examined by age group. Of those born before 1957, seven tested seronegative for measles and six were borderline. Of the individuals born between 1959 and 1964, 12 tested seronegative and 3 were borderline. During measles outbreaks mass immunization of high-risk populations may not be justified. Although immunization is effective, there is only a small percentage of subjects in this population who do not have immunity to measles. Ideally, continuous screening of high-risk individuals should be conducted during measles outbreaks. However, these results indicate that measles immunization of persons born before 1957 should be considered because of the significant frequency of seronegativity and disease in this group. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measles - United States, first 26 weeks, 1989

Article Abstract:

The first 26 weeks of 1989 produced a total of 7,335 measles cases that were reported to the Centers for Disease Control. This represented a 380 percent increase over the 1,529 cases reported for the same period in 1988. No fatalities were documented, but 672 complications occurred, including otitis media (middle ear infection), pneumonia, diarrhea, and encephalitis (inflammation of the brain). A significant number of cases involved unvaccinated urban preschool children, primarily black and Hispanic. Lack of adequate vaccination was considered to be an important contributing factor to the increased incidence of measles. Attempts are being made to control measles outbreaks among these groups through programs such as intensified surveillance, door-to-door vaccination, vaccination clinics in emergency rooms, and lowering the recommended age for vaccination to 6 months during measles outbreaks (with revaccination to take place at 15 months). Lack of adequate vaccination was also believed to contribute to the increased incidence of measles reported in adults over 20 years old. However, more than half of the cases reported were in previously vaccinated children between 5 and 19 years. This may be the result of primary vaccine failure. To reduce this risk, a two-dose vaccination program has been recommended; an initial dose is given at 15 months, with a second dose at four to six years of age, or upon entering school. (Consumer Summary produced by Reliance Medical Information, Inc.)

Tale of the unexpected

Article Abstract:

A woman describes her experience of an early menopause. She knew from her teenage years that she was post-menopausal and sought answers to lots of related questions at the time. She takes hormone replacement therapy (HRT) but feels there is little information available on HRT for younger women. She has also been able to have a child through in vitro fertilisation and a donor egg. Her experience of health personnel over this issue was that they were dedicated but generally unwilling to enter personal dramas.